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Harold’s hernia

Because I was a small town lad, the folks with say-so at Georgia’s flagship institution only allowed me to visit the big city once or twice a year, the better to protect me from known excesses. It was on one of these occasions that I had a momentary glimpse of an excess in Atlanta. For those readers who are young and tender, or whose sensitivities are fragile, it may be best to select another story. It is precisely such sensitivities that are at the heart of the following episode.

Shortly after arriving in the rehab office, I was spotted by one of the counselors, Dorothy, who was also one of our graduate students at the University. She had emerged from her office somewhat abruptly looking for either a witness, or protection, or both. I was the nearest person with nothing better to do. She said she wanted me to “see something” in her office. Whatever it was, the urgency of her request overcame any reluctance I might have had at the time. Metropolitan excesses come in a wide assortment of varieties, and my curiosity was mushrooming as she led me into her office. When she shut the door behind her, I knew we were in for a treat.

Seated in her office was a man in his late forty’s or early fifties who could have passed for a street person. His clothes were baggy and un-kept, his hair had not been combed, but I knew he was alleging some sort of impairment. This was, after all, the rehab office serving all comers in the heart of Atlanta. One of the city’s many excesses was about to be revealed.

Dorothy introduced me to Harold, her client at the moment, and added that he insisted on showing us his impairment. While I thought I was a random visitor to her office, I suspected that she was loaded with background information on Harold as well as an adequate supply of medical reports.

Harold, it seems, had a hernia of such proportions that it required seeing to appreciate. Hernias, as well as many other impairments, vary from irrelevant to monumental. Dorothy was required by law to determine whether, or not, Harold’s hernia was of such severity as to be a substantial handicap to employment, and if so he would be legally eligible to receive tailored services through rehab. This was Harold’s path back to a productive life, and Dorothy was the gatekeeper on this path.

On command, Dorothy gave Harold the nod, and with that nod Harold rose from his chair and turned to face both of us directly. He unbuckled his baggy trousers which fell completely to the floor. He was wearing no undergarments. This was excess #1, which I had heard is common among street folks. Limited versions of this scene may be seen on the streets and in the malls of most cities today.

Excess #2 came into view immediately thereafter. While Harold’s private parts were hanging for Dorothy and me to see, Harold’s hernia was of the scrotal variety, in which abdominal contents descend from the abdomen into the male scrotum. From there, as it develops, the scrotum descends to reveal Harold’s alleged handicap to employment. Throughout thirty years in rehab, I had never before witnessed eligibility for services hanging, as it were, on the male scrotum. Atlanta’s excess had registered a solid ten on my scale of big city excesses.

Harold’s hernia was hanging at the same level as his knee. In the shock of the moment, it was hard to remember whether the hernia was hanging down the right, or the left trouser’s leg. At the knee level, it was about the size of a baseball bat, the end that hits the ball. It was not difficult to appreciate why Harold was wearing such baggy pants, nor even question why his hair may not have been groomed as carefully as others might like.
Dorothy was quick to say, “Thanks, Harold. Please get dressed now.” Moments later Dorothy asked Harold to wait outside, and she would get back to him in a few minutes.

It is likely that Dorothy had never before witnessed such an excess either. While she might have selected one of the secretarial staff to assist her with her assessment, this might have alarmed Harold unnecessarily. It would also have kept her from eliciting any gender specific information necessary for her to make an informed decision. For the assigned task she may also have believed that any male witness from out of town was a better choice than one of her fellow counselors, most all of whom were males.

After Harold was safely outside Dorothy closed the door one more time.
“Now help me translate Harold’s hernia into limitations in activities and functioning”, she said. “Then we can discuss whether Harold has a substantial handicap to employment”.

Drawing upon my best Latin and Greek terminology, I reviewed the basics. A few of the basics are gender specific, but the impairment to function deals primarily with general principles of physics and physiology. So I began my essay on Harold’s Hernia extemporaneously.

“Within the normal scrotum are two historically important glands, the testicles. Unless specified otherwise in your medical information, these glands are still somewhere within the structure we both observed. These glands are sensitive to harsh treatment when struck from the outside, and under stress may produce occasional or severe discomfort.”

“In this non-normal circumstance, a considerable amount of foreign matter is sharing the same space with the testicles. These foreign substances, like abdominal fluid or a loop of small intestine, are hanging through an enlarged inguinal canal and collecting within the scrotum. The weight of these substances has caused the pendulous scrotum to hang to Harold’s knees, where gravity, and Harold, jointly determine where and how it hangs.”

“As for limitations of activities and functioning, I think we can ignore any sexual relevance, which for most males has no connection to making a living. This pendulous structure would certainly interfere with normal walking, speed and gait. Running is certainly out of the question. Walking extensively would likely not be recommended because of discomfort or medical contraindications. There is a possibility of rupture of the scrotum, as well as several other complications if a loop of intestine is involved.”

“Standing, bending over, sitting, and even normal bathroom functions are impaired because of the abnormal structural presence. Discomfort is certainly an added complication with physical activity. Harold did not appear to be in any acute distress, but you could certainly ask him about this directly.”

With that I ended my only mini-lecture on the vocational relevance of the male scrotum. Dorothy was clearly thinking of surgical correction of this serious defect. Assuming that Harold has marketable skills, the removal of this hideous appendage would make it far more likely that Harold could return to supporting himself in the future.

As Harold seemed to have little modesty in displaying his extra appendage, I added:
“It might be important to tell Harold that what he had shown here today should not be shared with any prospective employer. While most employers are sympathetic and understanding, rarely do they hire an individual because they have a handicap.”

If corrected successfully it would be best to relegate this sordid history to the archives, and in its place Harold should emphasize his willingness to do the right thing on the job.

After I left, I presume Dorothy called Harold back into her office, and completed the necessary planning to get Harold, and his hernia back on track.